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Monday, June 6, 2011

Red flags raised with alarming medical board decisions

Red flags raised with alarming medical board decisions

Debra Friedman, Staff Writer
The state Department of Public Health, the body that investigates doctor misconduct, became aware of a troubling lawsuit and settlement in 2007.

A couple had sought the services of Dr. Ben Ramaley, a Greenwich obstetrician/gynecologist, to help them conceive in a 2002 fertility procedure. But the couple later knew something was wrong when their twin girls did not resemble them.

The couple sued Ramaley in 2005, claiming he had used his own sperm in the procedure. The lawsuit was settled within months.

In November 2009, Greenwich Time revealed that Ramaley was fined $10,000 and allowed to keep an unrestricted license after the state Department of Public Health found he used the "wrong man's sperm" in the procedure, resulting in the twins being born without the DNA of their intended father.

Health department officials went no further, however, declining to order a DNA test to resolve the allegation that Ramaley was the girls' father, even though they had the authority to do so.

Patient advocates and state lawmakers point to the Ramaley case as one of the most glaring examples of the failing system that investigates physician wrongdoing in Connecticut.

Perhaps the most alarming aspect of the case was the fact the Connecticut Medical Examining Board, which adjudicates cases investigated by the state Department of Public Health, knew almost nothing about the history of the case before signing off on a consent order, according to board member's own admissions.

Dr. Dennis O'Neill, a former board member who was chairman during the Ramaley case, said he had no idea Ramaley, who still practices obstetrics and gynecology in Westport, was ever accused of using his own sperm in the procedure. The statement of facts in the consent order -- basically a plea bargain -- only states that Ramaley used the "wrong man's sperm."

"With a consent order, the board has only the information the department wants to give," said O'Neill, who retired from the board in 2008. "That case is a perfect illustration of why the two-department approach doesn't work as well as an independent-medical-board model."

Currently, the state Department of Public Health investigates cases and presents its findings to the board to make a decision. With consent orders, however, board members only hear a few brief statements of fact about the case. In many other states, the medical board is an independent entity that investigates cases on its own and has no attachment to other state government agencies.

Asked whether he would have liked to see the DPH compel Ramaley to take a paternity test, O'Neill said it was hard to comment because he knows so little about the case.

"It would have been nice for them to take that step, but it's hard to second-guess," he said.

Anne Doremus, a public member and current chairwoman of the board, said she also was not aware of that allegation during the time.

"With Ramaley, that probably should have gone to a hearing," Doremus said. "The DPH gave us all the evidence, and that is all we knew at the time."

In a hearing, board members hear all the evidence in a case. Statistics provided by the DPH show a majority of cases are adjudicated through a consent order.

In 2009, the DPH agreed with former state Attorney General Richard Blumenthal that it could have done more with the Ramaley case, but defended their actions. "(The department) said that going forward it would deal with such issues more aggressively and vigorously," the DPH said in a statement.

While Ramaley is perhaps the most alarming example of the failure of the two-pronged system, some controversial decisions have also come after a full hearing in which board members heard all the evidence.

Seven years ago, state officials were outraged when the medical examining board allowed Dr. Steven Herman, a Norwalk plastic surgeon, to keep his license after anesthesia complications during a cosmetic procedure left a woman in a coma.